Brunie Aurélie, Callahan Rebecca L, Mackenzie Amelia, Kibira Simon P S, Wayack-Pambè Madeleine
Health Services Research, FHI 360, Washington, DC, USA.
Contraceptive Technology Innovation, FHI 360, Durham, NC, USA.
Gates Open Res. 2019 Apr 11;3:1205. doi: 10.12688/gatesopenres.12953.2. eCollection 2019.
: Unmet need remains high in developing regions. New contraceptive technologies may improve uptake and use. This study examines desirable product characteristics. : We added a module to the female questionnaire of the PMA2020 surveys in Burkina Faso and Uganda and conducted 50 focus group discussions (FGDs) with women, 10 FGDs with men, and 37 in-depth interviews (IDIs) with providers across the two countries. FGDs with women and IDIs with providers included a semi-structured ranking exercise on pre-selected product characteristics. : Effectiveness, duration, few side effects, cost, and access were the characteristics most commonly reported as important in choosing a method by survey respondents across both countries. Half or more of women surveyed in each country would like a method that lasts at least one year, while 65% in Burkina Faso and 40% in Uganda said they would use a method causing amenorrhea. Qualitative findings show that women want methods with minimal and predictable side effects. Reactions to increased bleeding were negative, especially in Burkina Faso, but perspectives on reduced bleeding were more mixed. Women and providers preferred methods that are discreet and not user-dependent, and associate duration with convenience of use. Some women in Uganda expressed concerns about the invasive nature of long-acting methods, and cost was an important consideration in both countries. In the ranking exercise, discreet use and few side effects often ranked high, while causing amenorrhea and not requiring a pelvic exam often ranked low. : Product development should consider user preferences for success in these settings.
发展中地区未满足的需求仍然很高。新的避孕技术可能会提高接受率和使用率。本研究考察了理想的产品特性。我们在布基纳法索和乌干达的PMA2020调查女性问卷中增加了一个模块，并与女性进行了50次焦点小组讨论（FGD），与男性进行了10次FGD，并与两国的提供者进行了37次深入访谈（IDI）。与女性的FGD和与提供者的IDI包括对预先选定的产品特性进行半结构化排序练习。有效性、持续时间、副作用少、成本和可及性是两国调查受访者在选择方法时最常报告为重要的特性。每个国家接受调查的女性中，有一半或更多的人希望有一种持续至少一年的方法，而布基纳法索65%的女性和乌干达40%的女性表示她们会使用导致闭经的方法。定性研究结果表明，女性希望方法的副作用最小且可预测。对出血增加的反应是负面的，尤其是在布基纳法索，但对出血减少的看法则更为复杂。女性和提供者更喜欢隐秘且不依赖使用者的方法，并将持续时间与使用便利性联系起来。乌干达的一些女性对长效方法的侵入性表示担忧，成本在两国都是一个重要的考虑因素。在排序练习中，隐秘使用和副作用少往往排名靠前，而导致闭经和不需要盆腔检查往往排名靠后。产品开发应考虑用户偏好，以便在这些环境中取得成功。
